基于群体的中老年人认知变化轨迹模型：系统综述。

IF 12.4 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2025-08-07 DOI:10.1016/j.arr.2025.102855

Huan Zhang , Hongli Chen , Xiaotong Ding , Qing Wang , Jingjing Gu , Shuaifang Wei , Jiajun Xue , Yulin Liang , Zheng Li

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引用次数: 0

摘要

背景：认知健康是健康老龄化的重要组成部分。本研究旨在回顾采用基于群体的轨迹建模方法系统地检查认知轨迹，确定相关决定因素，并调查与健康结果的关系的研究。方法：在五个数据库中进行了系统的搜索，以确定两个或更多的认知轨迹。这项研究是在PRISMA声明之后进行的。结果：本研究最终纳入了2007年至2024年在多个国家发表的35项研究，样本量从318到19422名参与者。“高度稳定”和“适度下降”轨迹是最常观察到的模式。与稳定组相关的关键保护因素包括高等教育、积极的生活方式（例如，认知/体育活动、高质量和适当的睡眠时间、不吸烟）和强大的社会网络。患有心血管疾病、糖尿病和抑郁症的老年人往往会经历快速的认知衰退。尽管关注生物标志物和大脑结构变化的研究相对较少，但现有证据表明，APOE ε4携带较高的Aβ/总淀粉样蛋白负荷、升高的t-tau+和内鼻皮层变薄等因素与认知能力下降轨迹有关。此外，一些研究强调了与快速认知退化相关的重大后果，如痴呆、死亡率和残疾的高发。结论：相当大比例的老年人随着时间的推移保持认知功能，这可能得到认知/身体参与、健康睡眠、社会联系和疾病管理等保护策略的支持。与下降轨迹相关的不利结果强调了未来对可改变因素的研究的必要性。比较子组之间的预测因子可以深入了解认知弹性和主动保护。进一步探索生物学措施对于理解认知衰老和早期预防痴呆症至关重要。

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Group-based trajectory modelling for cognitive changes in middle-aged and older adults: A systematic review

Background

Cognitive health constitutes a critical component of healthy aging. This study aims to review studies that employed group-based trajectory modeling approaches systematically to examine cognitive trajectories, identify associated determinants, and investigate the relationship with health outcomes.

Methods

A systematic search was performed in five databases for articles that identified two or more cognitive trajectories. The study was conducted following the PRISMA statement.

Results

Thirty-five studies, published from 2007 to 2024 across multiple countries, with sample sizes ranging from 318 to 19422 participants, were ultimately included in this study. The “High Stable” and “Moderate Decline” trajectories were the most frequently observed patterns. Key protective factors associated with the stable group included higher education, active lifestyle (e.g., cognitive/physical activities, high quality and appropriate duration of sleep, no smoking), and strong social networks. Older people with cardiovascular diseases, diabetes, and depression tend to experience rapid cognitive decline. Although relatively few studies have focused on biomarkers and brain structural changes, available evidence suggests that factors such as APOE ε4 carriage higher Aβ/global amyloid load, elevated t-tau+ , and entorhinal cortical thinning are associated with cognitive decline trajectories. In addition, several studies highlighted significant consequences linked to rapid cognitive deterioration, such as high incidence of dementia, mortality, and disability.

Conclusion

A substantial proportion of aging individuals maintain cognitive function over time, which may be supported by protective strategies like cognitive/physical engagement, healthy sleep, social connection, and disease management. The adverse outcomes linked to decline trajectories underscore the need for future research on modifiable factors. Comparing predictors across subgroups provides insights into cognitive resilience and proactive protection. Further exploration of biological measures is crucial for understanding cognitive aging and enabling earlier dementia prevention.

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.